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S622
ESTRO 36
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just after radiotherapy. Apart of asthenia, by groups; A)
they showed weakness (87.5%) and anorexia (70%) in
relation with cytotoxic effects, and 50% in this group of
patients showed considerable to severe depression
feeling. B) Pain (50%), generally caused by the set-up
position and the skin effects of radiotherapy, and 31% of
this group of patients showed considerable to severe
depression feeling. C) Low degrees of Insomnia,
constipation and mild depression were also present in this
group.
It was found relationship between high degrees of fatigue
and females older than 45 years old, tumour poor
differentiation, advanced II-III stage, and hormonal
treatment when they were tested. In second term PS,
several skeleton bone or articular diseases. The presence
of mastectomy and thyroidal diseases were frequent in the
worst answer tests. Also depression status is determinant
in prognosis, but none common profile or clear
relationship between high degrees of fatigue and
biological factors as ki67, P-53, hormonal receptors,
perineural affection, C-her2neu/FISH, tumoral markers as
CA 15.3 were found
Conclusion
1. Quality of live and treatment toxicities differed among
patients under systemic treatment or radiotherapy, since
the toxicity is cumulative. 2. Asthenia is the main
symptom in all cases. 3. The data of high depression
redraw the need of psychological and social cares. 4.
International organisms recommend applying probate
quality of life tests in every oncology department, if
possible
EP-1143 Hypofractionated vs conventionally
fractionated breast radiotherapy: Economic
consequences.
A.C. Ciafre
1
, J.M. Torices
1
, E. Jordá
1
, D. Dualde
1
, R.
García
1
, E. Ferrer
1
1
Hospital Clinico Universitario, Oncologia Radioterapica,
Valencia, Spain
Purpose or Objective
Hypofractionated radiotherapy for post-operative breast
cancer has consolidated as the standard treatment for
breast cancer due to similar results compared with
mastectomy in terms of local relapse, disease recurrence
and survival rates. On clinical trials, Multiples fractionated
schemes have been tested in the past years,
demonstrating that hypofractionated whole-breast
irradiation was not inferior to standard radiation
treatment in women who had undergone breast-
conserving surgery for invasive breast cancer with clear
surgical margins and negative axillary nodes. The purpose
of this study was to compare the economic outcomes in
our institution resulting from an hypofractionated
treatment in selected patients.
Material and Methods
A retrospective review from January 1º 2010 to December
31º 2015 of hypofractionated whole-breast irradiation was
performed. Inclusion criteria was: Early breast cancer (I,
II) Breast-conserving surgery, Age >18 years and absence
of previous RT treatment at the same area. Pregnancy,
breastfeeding and axillary nodes involvement were
excluded. 3D conformal radiotherapy was delivered with
6-15 MV photons: 40 Gy in 15 fractions, 5 fractions per
week. Additionally, boost doses to the tumor bed in
patients <50 years, close margins of IDC or positive
margins on DCIS with an equivalent dose in 2Gy fractions
(EQD2) of 10-20 Gy. The estimated cost by treatment was
obtained multiplying the number of sessions received by
the stipulated cost of each session according to the law in
force. Additionally we calculated an estimated cost of the
treatment as if it has been performed with conventionally
fractionated schedule, comparing the total amount
between treatments.
Results
361 patients who fitted the inclusion criteria were treated
in our institution using hypofractionated schemes. The
cost by session was estimated in 285,53€ according with
the law in force provided by the Economic department of
our institution. 75,6% (n273) of patients received 15
fractions with an estimated cost by treatment of
1.169.245,35€ and the remain 24,4% of patients (n88)
received 18 fractions with an estimated cost of
452.279,52€. Comparing a standard irradiation in 25
fractions with hypofractionated irradiation in 15 fractions,
a total saving estimated on 779.496,9€ was obtained.
Likewise in patients who underwent boost doses to the
tumor bed receiving 18 fractions, a total saving of
301.519,68€ was calculated compared to a conventional
treatment of 30 fractions.
Conclusion
The increasing demand of treatments in health care
institutions makes necessary the implementation of cost-
efficacy strategies, in attendance of each patients needs
without letting a side the importance of optimization of
health resources. Hypofractionated schedules reduces the
total time of treatments which translates in a reduction of
sanitary personnel costs, time machine, waiting lists,
transportation and patient discomfort among others.
EP-1144 Old age impact on radiotherapy omission in
breast cancer patients
S. Cima
1
, B. Muoio
1
, P. Fanti
1
, A. Richetti
1
, C. Azinwi
1
, F.
Martucci
1
, K. Yordanov
1
, G. Pesce
1
, M. Valli
1
1
Istituto Oncologico della Svizzera Italiana, Radiation
Oncology, Bellinzona, Switzerland
Purpose or Objective
Increasing life expectancy and overall aging in the western
countries will improve the impact of breast cancer
treatment in old women. The aim of this study was to
analyse the impact of age on post-operative radiotherapy
(RT) omission in breast cancer patients, older than 69
years.
Material and Methods
We analysed retrospectively 384 women, treated from
January 2007 to June 2015, dividing them into three
subgroups: 70 to 79 years, 80 to 89 years and 90 years and
older.
Results
A total of 280 patients (72.9%) were treated with
conservative surgery. The adjuvant RT was given to 135
patients (71.4%) aged 70-79 years, 27 patients (34.2%)
aged 80-89 years and 3 patients (25%) older than 90 years.
RT was omitted in 115 (41.1%) cases. A significant
correlation was observed between age and RT omission,
comparing younger subgroup to the others (p<0.001 and
p=0.002), with a smaller number of older patients treated
with RT. The 2 and 5 year DFS of patients treated with
conservative surgery was 94.5% and 82.7% without
significant difference between age subgroups (p=0.36). No
significant difference in 2 and 5 years DFS was detected
(p=0.12) between patients treated with adjuvant RT and
conservative surgery alone (p 0.12). The 5 year OS was 81%
in patients aged 70-79 years; 71% in patients aged 80-89
years and 65% in patients older than 90 years, with a
significant difference (p=0.009). The 5 year OS in patients
treated with adjuvant RT was 79% while it was 75 % in
patients treated with conservative surgery alone, without
significant difference (p=0.11). Mastectomy was
performed in 124 patients: 17 patients (13.7%) received
RT while 107 (86.3%) no further RT, with omission in 22
patients (17.7%).The adjuvant RT was given to 13 patients
(16.7%) aged between 70-79 years, 4 patients (10.3%) aged
between 80 and 89 years, while no patients older than 90
years was treated with post-mastectomy RT. No
statistically significant difference in term of RT omission